Abstract 18070: Disparities in Advanced Heart Failure Therapy
Background and Objective: Disparities in healthcare delivery are increasingly recognized. In this study, we explored disparities based on gender, race, age, region, and hospital type, in receiving advanced heart failure therapies (AHFT) defined as mechanical circulatory support (MCS) and heart transplantation (HT).
Methods: Using data from the Nationwide Inpatient Sample (NIS), the largest all-payer inpatient health care database in the United States, we identified all hospitalizations between 2005-2011 for patients 18-85 years old, with the diagnosis of congestive heart failure, cardiomyopathy, or cardiogenic shock, and with no known contraindications to AHFT. Multivariate logistic regression analysis was used to determine the likelihood of receiving AHFT based on gender (men versus women), race (White versus Black, Hispanic, or others), age (≤50 versus 51-70 or ≥71 years old), hospital type (teaching versus non teaching), and geographic region (West versus Northeast, Mid-west, or South).
Results: A total of 3,789,875 hospitalizations met our inclusion criteria, of which 3,769 (0.1%) patients received AHFT: 1,923 (51.0%) received MCS and 1,846 (49.0%) received HT. The following were associated with lower likelihood of receiving AHFT (table 1): female gender, non-white race, older age, non-teaching hospital, and Midwest, Northeast or South geographical region.
Conclusion: Gender, race, age and regional disparities exist in the delivery of AHFT therapy. As the population of patients with end-stage heart failure continues to grow, effective public health research and policies are needed to identify the sources of disparities and to ensure equity in delivering AHFT.
Author Disclosures: K. Murad: None. S.S. Roy: None. N. Harcourt: None. M. Colvin: None.
- © 2014 by American Heart Association, Inc.